In this issue of the Journal, Priest and colleagues report a further study showing the lack of effectiveness of "debriefing" after a traumatic event in preventing psychological disorders — in this case, in women after childbirth.1 Their use of debriefing for this purpose indicates how widely the enthusiasm for this intervention has spread in the past decade. On superficial examination, early interventions are an appealing and inexpensive approach to dealing with events that can be followed by predictable psychiatric morbidity.2 This negative study adds to the now substantial evidence that psychological debriefing has no value in prevention.3,4
- 1. Priest S, Henderson J, Evans S, Hagan R. Stress debriefing after childbirth: a randomised controlled trial. Med J Aust 2003; 178; 542-545.<eMJA full text>
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- 3. Bisson J, McFarlane A, Rose S. Psychological debriefing. In: Foa E, Keane T, Friedman M, editors. Effective treatments for PTSD. Practice guidelines from the ISTSS. New York: Guilford Press, 2000.
- 4. Rose S, Bisson J, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review). The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
- 5. Sims, M, Abramson M, Forbes A, et al. Australian Gulf War Veterans' Health Study. Canberra: Department of Veterans Affairs, 2003.
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- 7. Mitchell J. When disaster strikes. The critical incident stress debriefing process. J Emerg Med Serv 1983; 8: 36-39.
- 8. McFarlane AC. Can debriefing work? In Raphael B, Wilson JP, editors. Critical appraisal of theories of interventions and outcomes, with directions for future research in psychological debriefing, theory, practice and evidence. London: Cambridge University Press, 2000: 327-336.
- 9. Wolfe J, Erickson DJ, Sharkansky EJ, et al. Course and predictors of posttraumatic stress disorder among Gulf War veterans: a prospective analysis. J Consul Clin Psychol 1999; 67: 520-528.
- 10. Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry 2000; 61 Suppl 5: S4-S14.
- 11. Murray CJL, Lopez AD, editors. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Geneva: World Health Organization, 1996.
- 12. Ballard CG, Stanley AK, Brockington IF. Post-traumatic stress disorder (PTSD) after childbirth. Br J Psychiatry 1995; 166: 525-528.
- 13. McFarlane AC. Traumatic stress in the 21st century. Aust N Z J Psychiatry 2000; 34: 6, 896-902.
- 14. Harvey AG, Bryant RA. Relationship of acute stress disorder and posttraumatic stress disorder following motor vehicle accidents. J Consult Clin Psychol 1998; 66: 507-512.
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